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Contact Information

MELISSA A CLARK, LPN
113 CHENEY ST
SYRACUSE, NY13207
 Phone: 315-478-9463
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Licensed Practical Nurse

164W00000X
Indicates primary specialty

NPI Profile & details for MELISSA A CLARK · (Female)

NPI Number 1114160199
Status Active
Credentials LPN (Licensed Practical Nurse)
Entity Individual
Enumeration date 04/07/2009
Last updated 04/07/2009 - About 10 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 291875
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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